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Colonoscopy

Last updated March 18, 2019

A Colonoscopy is an endoscopic procedure that uses an optical instrument to examine the inner linings of the large intestine and the distal end of the small intestine. The procedure is also used to extract tissue for pathological examination.


Background Information:

What are the other Names for the Procedure?

  • Colonoscopic Surgical Procedure
  • Endoscopic Examination of Colon
  • Lower Endoscopy

What is Colonoscopy surgical procedure?

A Colonoscopy is an endoscopic procedure that uses an optical instrument to examine the inner linings of the large intestine and the distal end of the small intestine. The procedure is also used to extract tissue for pathological examination.

What part of the Body does the Procedure involve?

A Colonoscopy procedure involves the anus, parts of the large intestine (rectum, sigmoid colon, and colon), and terminal portion of the small intestine.

Why is the Colonoscopy surgical procedure Performed?

There could be various reasons for performing a Colonoscopy procedure. Some of these include:

  • To examine and diagnose diseases of the colon, rectum, or large intestine
  • View abnormalities and disorder in the inner lining of the intestine
  • Bleeding in stools
  • To remove a foreign object or matter, causing blockage
  • Suspected cancer of the intestine or polyps
  • Extract tissue specimen for pathological examination
  • Colonoscopy is a screening method used to check for any abnormal growth in the colon, in individuals more than 50 years of age or earlier; if there is a family history or colon cancer.

What are some Alternative Choices for the Procedure?

To study and diagnose any ailment related to the large intestine, a Colonoscopy procedure remains the gold standard technique. However, barium enema x-ray studies, can also serve as an alternative.

What are the Recent Advances in the Procedure?

Colonoscopy is an excellent procedure, which is used to diagnose any problems related to the large intestine.

What is the Cost of performing the Colonoscopy surgical procedure?

The cost of Colostomy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Colonoscopy procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://my.clevelandclinic.org/services/colonoscopy/hic_colonoscopy_procedure.aspx (accessed on 24th July, 2012)

http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/ (accessed on 24th July, 2012)

http://www.mayoclinic.com/health/colonoscopy/MY00621 (accessed on 24th July, 2012)

Prior to Colonoscopy surgical procedure:

How is the Colonoscopy surgical procedure Performed?

  • Before undergoing a Colonoscopy, the physician prescribes laxatives to clear the bowel
  • Next the colonoscope is lubricated and introduced in the large intestine through the anus
  • The colonoscope may be passed through the whole inner lining of the large intestine to examine, diagnose and extract tissue sample for pathological examination
  • In some cases, the physician may immediately decide to treat an abnormality including a polyp and tumor for examination
  • Also, biopsies of large intestine may be performed before withdrawing the colonoscope

Where is the Procedure Performed?

A Colonoscopy procedure is performed in a hospital, out-patient facility, or an endoscopy suite. The individual can go home the same day.

Who Performs the Procedure?

The Colonoscopy is performed either by a gastroenterologist, general surgeon, or a colorectal surgeon, along with an anesthesiologist (only if really necessary).

How long will the Procedure take?

The procedure may take anywhere between 30-60 minutes. If necessary, the physician may ask the individual to wait for a longer time period at the healthcare facility, for observation.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Also, inform the physician, if a barium x-ray test was performed
  • The patient is also suggested a 1 or 2 day preparation procedure, where the patient is asked to follow a liquid diet, 1-2 days before the procedure. The evening before the Colonoscopy, a laxative is prescribed
  • Normally local anesthesia is not used; however, do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any deodorant or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the procedure
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Colonoscopy procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Colonoscopy surgical procedure?

The individual has to undergo certain tests prior to a Colonoscopy procedure, such as:

  • X-ray of the gastrointestinal tract
  • Routine blood and urine analysis
  • Stool analysis
  • The physician may suggest further tests depending on the health of the individual and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Colonoscopy?
  • Why is this procedure necessary? 
  • What does the procedure involve? Is it painful?
  • How will this procedure help?
  • How soon should I get it done? Is there an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • Do I have to take any special diet prior to the procedure?
  • Will it affect the bowel movement in any way?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • How long will it take to recover? When can I resume normal work?
  • After recovering from the procedure, are there any follow ups or tests? If yes, how often?
  • How many procedures have you performed? 
  • What are the costs involved?

During the Colonoscopy surgical procedure:

What kind of Anesthesia is given, during the Procedure?

During the procedure, no anesthesia is administered; however, intravenous sedation is given.

How much Blood will you lose, during the Procedure?

The endoscopic procedure is less invasive and there is little, or no blood loss involved.

What are the possible Risks and Complications during the Colonoscopy surgical procedure?

The possible risks or complications that may arise during the procedure are as follows:

  • Excessive bleeding
  • Infection
  • Injury to the inner lining of the large intestine
  • Accidental injury to the colon
  • Perforation of the colon

What Post-Operative Care is needed at the Healthcare Facility after the Colonoscopy surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise. 

After the Colonoscopy surgical procedure:

What are the possible Risks and Complications after the Colonoscopy surgical procedure?

Post Colonoscopy, the following complications may arise:

  • Infection
  • Allergy or side effects to the sedative
  • Perforation of the colon
  • Discomfort

What is the Prognosis after the Surgery?

A Colonoscopy procedure provides information that helps the physician to successfully diagnose or rule out any disease or disorders of the colon. The recovery from the procedure is excellent.

When do you need to call your Physician?

Do contact your surgeon/physician if you notice any of the following symptoms:

  • Bloating
  • Abdominal pain
  • Rectal bleeding for more than 24 hours
  • Blood in the stool
  • Fever
  • Dizziness
  • Muscle ache
  • Nausea or vomiting
  • Signs of infection
  • If any new symptom or discomfort is observed

What Post-Operative Care is needed at Home after the Colonoscopy surgical procedure?

Generally, after a Colonoscopy, no particular care is necessary at home.

How long does it normally take to fully recover, from the Procedure?

It takes about 4 days to completely recover from the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and is later disposed, as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

The tissue removed is processed in the laboratory under a pathologist's supervision

The slide(s) are prepared once the tissue is processed, and this is examined by a pathologist and a pathology report issued

Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Colonoscopy surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility charges and the physician charges. Alternatively, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from

  • the hospital, outpatient facility or the physician’s office
  • the gastroenterologist or general surgeon or colorectal surgeon
  • a pathologist (if the tissue was sent for analysis)

The patient is advised to inquire and confirm the type of billing, before a Colonoscopy is performed. 

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 4, 2013
Last updated: March 18, 2019